Geographic Preference Statement for Senior Administrative Law Judge Applicant

Application for Senior Administrative Law Judge & Geographic Preference Statement for Senior Administrative Law Judge

Documents and Forms

Document Name Document Type
Form OPM 1655-A Geographic Preference Statement for Senior Administrative Law Judge Applicant Form and Instruction
OPM 1655-A Geographic Preference Statement for Senior Administrativ OPM Form 1655-A (2027).pdf Form and Instruction
OPM 1655-A Geographic Preference Statement for Senior Administrativ OPM Form 1655-A (2027).pdf Form and Instruction
OPM Form 1655-A - Track Changes.pdf OPM Form 1655A with track changes IC Document
OPM Form 1655-A - Track Changes.pdf OPM Form 1655A with track changes IC Document

Information Collection (IC) Details

IC Title:	Geographic Preference Statement for Senior Administrative Law Judge Applicant	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 5 CFR 930.201

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	OPM 1655-A	Geographic Preference Statement for Senior Administrative Law Judge Applicant	OPM Form 1655-A (2027).pdf	opm.gov	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records
Title: OPM Central 6	FR Citation: 60 FR 63084

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	200	0	200
Annual IC Time Burden (Hours)	83	16	67
Annual IC Cost Burden (Dollars)	4,844	1,556	3,288

Documents for IC

Title	Document	Date Uploaded
OPM Form 1655A with track changes	OPM Form 1655-A - Track Changes.pdf	06/25/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.